HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d U
Date: 9/815 Permit Number: X56 1 13
RECE1V D SEP 0 81015
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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PROPOSED IMPROVEIVIENT`LOCATION„
Address: G /l/c f t./
Legal Description:
Property Tax ID#: 0v0 -s Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
remove meter pedestal install 150 meter combo pack on 2" alum strut stand
'CONSTRUCTION:INFORMATION
,
Adclitional work to be nertormed under this permit-check all that appy:
HVAC Gas Tank Gas Piping _Shutters I]Windows/Doors
✓❑_Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name tN4/j Yr - /fol,�,.� ( rc_� Name: John Law
Address: 206 /be Nf« /3/v7/ Company: Law's Electrical Service Inc
City: c h s r, r3 r--1 State: r/ Address: 5158 NW Prim St
Zip Code: 3L4057 Fax: City: Pt ST Lucie State:Fl
Phone No. 1:�o ' Z/Llr— S-/7 3! Zip Code: 34983 Fax:
E-Mail: Phone No. 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: johnlaw5158@aol.com
from the Owner listed above) State or County License: 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
LSUPPLEMENTACONSTRUCTION LIENIAW INFORMATION: j
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature Owner/Lessee/Agent Signature of C tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S k Ly COUNTY OF SA. L,�
Theoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
forg
this day of Se 20 Eby this-t-day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notaryblic-State of Florid NN
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1 DEA A of F
PersonallyKnowny OR Prod• ���NS ����\0�6 Personally Known Stake
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S!<a ;1Y ,,., '6� �§t�rrtp�t��s ti
Type of Identification Produc c e� Type of Identification Pro
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Commission No. Commission No.
Revised 07/15/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS